Patient's need for endodontic treatment in a short period is on the rise nowadays. Technological developments in instruments and materials are allowing single-visit endodontic treatment to be performed. The success of an endodontic treatment is also influenced by the restoration, in consideration of the remaining tooth structure. This becomes a challenge for the clinician if the cavities are large or if minimal tooth structure remains, so it needs a
minimally invasive restoration like morphology-driven preparation technique. This case report aims to describe the single-visit endodontic treatment and minimally invasive indirect restoration of the mandibular first molar. A 13-year-old girl came to the Dental Hospital of Hasanuddin University with complaints of cavities in the mandibular left posterior tooth and pain for one month. The patient had taken analgesic medication but was afforded no relief. Intraoral examination showed tooth #36 with extensive cavities reaching the proximal area, a positive thermal test, and no pain to percussion. The case diagnosis was asymptomatic irreversible pulpitis. The treatment plan was a single-visit endodontic treatment and minimally invasive indirect restoration.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Pulpitis ; Tooth ; Molar

BACKGROUND AND OBJECTIVES

Orthodontic tooth movement is driven by bone remodeling influenced by systemic factors, including caffeine and ethanol. This study aimed to investigate the effects of caffeine and ethanol on the expression of Receptor Activator of Nuclear Factor κβ (RANK) and Osteoprotegerin (OPG), key bone remodeling biomarkers, during orthodontic tooth movement.

METHODS

A laboratory experimental study was conducted on 30 male Wistar rats divided into three groups: K1 (orthodontic force only), K2 (force + caffeine), and K3 (force + ethanol). Orthodontic force was applied using Ni-Ti coil springs. Caffeine and ethanol were administered orally daily. On days 7 and 14, maxillary tissues were collected and analyzed via immunohistochemistry for RANK and OPG expression. Data were analyzed using One-Way ANOVA and Independent Sample T-tests with significance at pRESULTS

Caffeine and ethanol administration increased RANK and OPG expression compared to controls; however, only the ethanol group showed a significant increase in RANK expression on day 14 (p = 0.044). OPG expression was significantly higher in treatment groups at both time points (pCONCLUSION

Caffeine and ethanol modulate bone remodeling marker expression during orthodontic force application, with ethanol significantly increasing RANK expression at later stages. Further studies are needed to clarify the clinical implications for orthodontic treatment.

Animals ; Tooth Movement Techniques ; Tooth Movement ; Osteoprotegerin ; Role ; Movement ; Ethanol ; Bone Remodeling ; Caffeine ; Immunohistochemistry

Periodontitis is a common oral disease caused by bacteria coupled with an excessive host immune response. Stem cell therapy can be a promising treatment strategy for periodontitis, but the relevant mechanism is complicated. This study aimed to explore the therapeutic potential of mitochondria from human embryonic stem cell-derived mesenchymal stem cells (hESC-MSCs) for the treatment of periodontitis. The gingival tissues of periodontitis patients are characterized by abnormal mitochondrial structure. Human gingival fibroblasts (HGFs) were exposed to 5 μg/mL lipopolysaccharide (LPS) for 24 h to establish a cell injury model. When treated with hESC-MSCs or mitochondria derived from hESC-MSCs, HGFs showed reduced expression of inflammatory genes, increased adenosine triphosphate (ATP) level, decreased reactive oxygen species (ROS) production, and enhanced mitochondrial function compared to the control. The average efficiency of isolated mitochondrial transfer by hESC-MSCs was determined to be 8.93%. Besides, a therapy of local mitochondrial injection in mice with LPS-induced periodontitis showed a reduction in inflammatory gene expression, as well as an increase in both the mitochondrial number and the aspect ratio in gingival tissues. In conclusion, our results indicate that mitochondria derived from hESC-MSCs can reduce the inflammatory response and improve mitochondrial function in HGFs, suggesting that the transfer of mitochondria between hESC-MSCs and HGFs serves as a potential mechanism underlying the therapeutic effect of stem cells.
Humans ; Gingiva/cytology* ; Fibroblasts/metabolism* ; Mitochondria/physiology* ; Mesenchymal Stem Cells/cytology* ; Animals ; Periodontitis/therapy* ; Mice ; Reactive Oxygen Species/metabolism* ; Inflammation ; Lipopolysaccharides ; Human Embryonic Stem Cells/cytology* ; Cells, Cultured ; Adenosine Triphosphate/metabolism* ; Male

Tooth eruption is a localised event whereby the signals for eruption for a given tooth are synthesised in the dental follicle of that tooth with a possible cross talk of signals coming from the adjacent stellate reticulum. The eruption process requires alveolar bone resorption that is primarily regulated by the dental follicle. This is reflected by the fact that failures of eruption often can be traced to either osteoclast deficiencies or to dental follicle abnormalities. Recent advances in application of molecular techniques to animal models allowed for better understanding of gene regulatory events involved in the physiology of tooth eruption. This article attempts to consolidate and organise the facts that offshoot from animal studies.
Tooth Eruption ; Dental Sac ; Molecular Biology

OBJECTIVE

To discuss a rare case of ectopic intranasal eruption of a tooth presenting as chronic rhinosinusitis focusing on the cause of the delayed diagnosis and emphasizing the role of otorhinolaryngologists in the management of this disease entity.

METHODS

Design: Case Report

Setting: Tertiary Government Training Hospital

Patient: One

RESULTS

A 25-year-old, partially edentulous woman initially presented with a four-year history of foul-smelling right nasal discharge accompanied by nasal congestion, nasal pain, and epistaxis. Several general physicians prescribed unrecalled antibiotics and pain medications which provided only temporary relief of the symptoms. Due to the persistence of the foul-smelling discharge which was recalcitrant to medications, culture and sensitivity testing at our institution revealed moderate growth of pseudomonas aeruginosa and computed tomography scans of the paranasal sinuses showed a right intranasal tooth, thickening of the inferior turbinate and septal deviation to the right. Following endoscopic removal of the intranasal tooth and septoplasty, there was resolution of symptoms and no complications.

CONCLUSION

Ectopic intranasal eruption of tooth has not yet been reported in the Philippines. Delays in diagnosing and starting proper management can lead to morbidity and serious complications such as development of antibiotic resistance. A high index of suspicion by an ENT-HNS physician with thorough nasal physical examination could have aided in the early diagnosis and management of the intranasal tooth.

Human ; Bacteria ; Female ; Adult: 25-44 Yrs Old ; Pseudomonas Aeruginosa ; Tooth

INTRODUCTION: Antimicrobial resistance (AMR) poses a critical global health threat, with millions of deaths attributed to it annually. Antibiotic stewardship to combat AMR is the responsibility of all healthcare professionals. Despite evidence suggesting that it is unnecessary, dentists routinely prescribe prophylactic antibiotics following third molar (3M) surgeries. METHOD: This mixed-methods study examined the behavioural barriers influencing antibiotic prescribing practices within the Division of Oral and Maxillofacial Surgery at the National University Centre for Oral Health Singapore. This study used the capability, opportunity and motivation for behavioural change or COM-B framework to implement interventions targeting the behavioural barriers. RESULTS: Pre- and post-intervention data over 6 months showed a significant reduction in antibiotic prescriptions from 84.45% to 20.89%, following the implementation of COM-B strategies (P<0.001). Qualitative feedback from focus group discussions highlighted a positive shift in clinicians' attitudes towards antibiotic reduction, acknowledging the minimal infection risk associated with non-prescribing practices. Notably, complication rates remained stable throughout the study period, indicating no adverse effects from reduced antibiotic usage. CONCLUSION These findings demonstrated that the COM-B model can be successfully applied to modify deeply ingrained prescription habits, and underscored the effectiveness of a structured behavioural change intervention in enhancing compliance with antibiotic stewardship guidelines. The study advocates continuation of initiatives to sustain this positive trend and mitigate AMR in clinical practice.
Humans ; Molar, Third/surgery* ; Anti-Bacterial Agents/therapeutic use* ; Singapore ; Antimicrobial Stewardship/methods* ; Practice Patterns, Dentists'/statistics & numerical data* ; Antibiotic Prophylaxis ; Female ; Attitude of Health Personnel ; Male ; Tooth Extraction ; Adult ; Focus Groups ; Practice Patterns, Physicians'

PURPOSE: Orotracheal intubation is one of the most frequently used techniques in emergency procedures and especially in anesthesia and resuscitation. Teeth may be "victims" of the orotracheal intubation. Several factors may predispose to these accidents. The aim of this study is to determine the incidence of oral trauma that occurs during scheduled and urgent oral tracheal intubation, and identify the risk factors, the types and locations of these dental injuries. METHODS: It is a cross-sectional study that lasted 6 months from June to November 2022. This study was carried out in several departments. An examination of the dental and periodontal status of patients who will undergo surgery under general anesthesia was performed before the operation according to the surgical program. Yet, in emergency settings, this examination was not possible. Patients with anterior edentation and patients refusing participation in the study were excluded. After the surgery, included patients were examined to detect eventual dental trauma such as fracture, luxation, and contusion. Collected data were entered and analyzed using SPSS version 18 software. The Wilcoxon Mann-Whitney U test was used to compare quantitative variables. The Chi-square test was used to compare qualitative variables with a statistical significance level of 5% (p < 0.05). RESULTS: There were 43 patients included in the study, and dental trauma was noted in 11 patients (25.6%). Their mean age was (59.8 ± 15.4) years. The statistical analysis shows that there is a significant relationship between age (over 40 years old) and trauma (p = 0.004). Among the traumatized group, orotracheal intubation was undergone for 8 cases according to the surgical program whereas it was performed, for 3 cases, in emergency settings. The difference between the 2 types of intervention is statistically significant (p = 0.045). The odds ratio was 0.086 (95% CI: 0.008 - 0.942). A Mallampati score of 1 was rated for 6 injured (54.5%). The difference between the difficulty of the intubation evaluated by the Mallampati score and the occurrence of trauma was statistically insignificant (p = 0.278). The dental partial dislocation was the most frequent trauma (6 cases, 54.5%). The maxillary teeth were the most affected (n = 13, 72.2%). CONCLUSION According to the present study, the incidence of orotracheal intubation dental traumas is relatively high. The age of the patient is one of the factors predisposing to these traumas. In scheduled surgery, orotracheal intubation is quietly performed during general anesthesia, and the risk of incidence of dental trauma is reduced than in emergency settings.
Humans ; Intubation, Intratracheal/adverse effects* ; Male ; Female ; Prospective Studies ; Tooth Injuries/epidemiology* ; Cross-Sectional Studies ; Adult ; Middle Aged ; Risk Factors ; Aged ; Adolescent ; Young Adult ; Incidence

Complex crown-root fractures in the esthetic zone refer to a type of dental trauma occurring in the anterior region, characterized by concurrent fractures involving both the crown and the root, with associated pulp exposure and periodontal tissue injury. These injuries consistently exhibit critical anatomical features, including a fixed palatal fracture location below the alveolar crest, compromised residual tooth structure, and frequent encroachment of the biological width. To predict treatment outcomes, a risk assessment framework based on the restoration-tooth-periodontium interface was developed. Resistance risk was evaluated by assessing the type of residual dentin ferrule and the length of the root within the alveolar bone, while periodontal risk was assessed according to gingival phenotype and alveolar bone morphology. Based on these risk dimensions and the principles of aesthetics, stability, and minimally invasive treatment, a diagnostic classification system was established to categorize fractures into three types: favorable, intervention and high-risk. Type-specific management strategies were proposed: for favorable cases, crown lengthening combined with deep margin elevation to reduce periodontal risk is recommended; for intervention cases, orthodontic extrusion or surgical extrusion is applied to simultaneously address both ferrule deficiency and biological width violation; for high-risk cases, extraction followed by implant restoration is advised due to limited root preservation value. The presented classification enables clinicians to adopt a scientific and structured approach to treatment planning for these complex crown-root fractures in the aesthetic zone.
Humans ; Tooth Fractures/therapy* ; Tooth Root/injuries* ; Risk Assessment ; Tooth Crown/injuries* ; Periodontium ; Esthetics, Dental ; Dental Restoration, Permanent/methods*

BACKGROUND: Dental caries is a chronic childhood disease and one of the most prevalent public health problems worldwide. Lead is a heavy metal that is taken up by the teeth and bones. However, the association between lead exposure during pregnancy, when the tooth germs are formed, and the prevalence of dental caries in the primary dentition remains unclear. This study aimed to examine the association between maternal blood lead levels and the prevalence of dental caries in the primary dentition of children. METHODS: This cross-sectional study was conducted as an Adjunct Study to the Japan Environment and Children's Study (JECS), which is an ongoing nationwide birth-cohort study. Among children participating in the JECS at the University of Occupational and Environmental Health Sub-Regional Center, those aged 7-8 years underwent oral examination and questionnaire administration. The dft (i.e., sum of the number of decayed and filled primary teeth) was then determined. The dft numerically expresses the dental caries prevalence in the primary dentition (larger value indicates more prevalent dental caries). Poisson regression analyses with robust standard errors were performed to evaluate the association between maternal blood lead levels during pregnancy, measured using frozen samples, and the dft. RESULTS: The study included 139 children, of whom 54.7% were girls, and 89.2% were 7 years old. The median maternal blood lead level was 6.1 ng/g (25-75 percentile, 5.0-7.3). The median dft was 0 (25-75 percentile, 0-4). After adjusting for covariates including age, sex, and oral health status and behavior, maternal blood lead levels were significantly associated with increased dft (prevalence ratio, 1.6; 95% confidence interval, 1.3-1.8; per one standard deviation increase in natural log-transformed maternal blood lead levels). CONCLUSIONS This study found an association between maternal blood lead levels and the prevalence of dental caries in the primary dentition of children aged 7-8 years. Maternal exposure to lead during mid- to late-term pregnancy may affect the caries susceptibility of children after birth.
Humans ; Lead/blood* ; Female ; Dental Caries/epidemiology* ; Prevalence ; Tooth, Deciduous ; Male ; Japan/epidemiology* ; Child ; Cross-Sectional Studies ; Pregnancy ; Adult ; Maternal Exposure/adverse effects* ; Environmental Pollutants/blood* ; Prenatal Exposure Delayed Effects/epidemiology*

OBJECTIVE: To explore the effects of two methods of smear layer removal on the surface properties of dentin. METHODS: Sixty extracted sound third molars were collected in this study, and were prepared as uniform dentin specimens with smear layer. All specimens were randomly divided into three groups: Control group, ultrasonic treatment (UT) group and etched treatment (ET) group. Scanning electron microscope (SEM) were used to observe the surface micromorphology of all three groups. Then, the surface elements, mineral phases and functional groups were analyzed by energy dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD) and flourier transformed infrared spectrometer (FTIR) respectively. The mechanical properties, hydrophilicity and biocompatibility were also further evaluated. RESULTS: It was revealed that dentin tubules of UT and ET groups were exposed, but lots of dentin debris piled up on the surface of the control one which covered up dentin tubules on the surface. The EDX results should that the weaker peak value of calcium and phosphorus in ET group than control and UT groups. Characteristic peaks of hydroxyapatite could be seen by XRD in all of the three groups, but lower distinctive peaks of amide Ⅰ, Ⅱ and Ⅲ bands of collagen of the dentin surface in control group than in ET and UT groups. The microhardness results showed that ET group was lower than control and UT groups, the difference was significant (P < 0.05). Better hydrophilicity of ET group was investigated (P < 0.05) than control group and UT group. Cells could be observed to adhere normally to dentin surface of each group which meant that all of the three groups had good biocompatibility. CONCLUSION Both UT and ET could effectively remove the smear layer on the surface of dentin and had no adverse effect of the dentin micromorphology and biocompatibility. The ultrasonic removal of the smear layer did not influence the mineral structure, hydrophilicity and mechanical properties of dentin surface. Although ET can effectively improve the hydrophilicity of dentin but decreased mechanical properties and the content of calcium and phosphorus.
Dentin/ultrastructure* ; Humans ; Surface Properties ; Smear Layer ; Molar, Third ; Microscopy, Electron, Scanning ; Dental Etching/methods*